Bartholmai Brian J, Koo Chi Wan, Johnson Geoffrey B, White Darin B, Raghunath Sushravya M, Rajagopalan Srinivasan, Moynagh Michael R, Lindell Rebecca M, Hartman Thomas E
*Department of Radiology, Division of Thoracic Radiology Departments of †Immunology ‡Biomedical Engineering and Physiology, Mayo Clinic, Rochester, MN.
J Thorac Imaging. 2015 Mar;30(2):139-56. doi: 10.1097/RTI.0000000000000137.
Pulmonary nodules are commonly detected in computed tomography (CT) chest screening of a high-risk population. The specific visual or quantitative features on CT or other modalities can be used to characterize the likelihood that a nodule is benign or malignant. Visual features on CT such as size, attenuation, location, morphology, edge characteristics, and other distinctive "signs" can be highly suggestive of a specific diagnosis and, in general, be used to determine the probability that a specific nodule is benign or malignant. Change in size, attenuation, and morphology on serial follow-up CT, or features on other modalities such as nuclear medicine studies or MRI, can also contribute to the characterization of lung nodules. Imaging analytics can objectively and reproducibly quantify nodule features on CT, nuclear medicine, and magnetic resonance imaging. Some quantitative techniques show great promise in helping to differentiate benign from malignant lesions or to stratify the risk of aggressive versus indolent neoplasm. In this article, we (1) summarize the visual characteristics, descriptors, and signs that may be helpful in management of nodules identified on screening CT, (2) discuss current quantitative and multimodality techniques that aid in the differentiation of nodules, and (3) highlight the power, pitfalls, and limitations of these various techniques.
肺结节在高危人群的胸部计算机断层扫描（CT）筛查中很常见。CT或其他检查方式上的特定视觉或定量特征可用于描述结节为良性或恶性的可能性。CT上的视觉特征，如大小、密度、位置、形态、边缘特征和其他独特“征象”，可能强烈提示特定诊断，一般可用于确定特定结节为良性或恶性的概率。连续随访CT上大小、密度和形态的变化，或其他检查方式（如核医学检查或MRI）上的特征，也有助于肺结节的特征描述。影像分析可以客观且可重复地量化CT、核医学和磁共振成像上的结节特征。一些定量技术在帮助区分良性与恶性病变或对侵袭性与惰性肿瘤的风险进行分层方面显示出巨大潜力。在本文中，我们（1）总结了可能有助于管理筛查CT发现的结节的视觉特征、描述符和征象，（2）讨论有助于区分结节的当前定量和多模态技术，（3）强调这些各种技术的优势、陷阱和局限性。
